title: Fertility, pregnancy outcomes and deliveries following myomectomy: experience of a French Caribbean University Hospital.
abstract: BACKGROUND
  Myoma is the most common benign tumor in women of childbearing age, with a high frequency in Afro-Caribbean than in other women. Depending on their number, size and location, myomas are suspected to be a cause of infertility. Conservative treatment by myomectomy is possible for symptomatic patients wishing to preserve their fertility.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the fertility of patients undergoing myomectomy in the University Hospital of Pointe-à-Pitre, Guadeloupe.
  
  
  METHODS
  We conducted a retrospective study including all patients under age 42 who had conservative surgery from January 1st, 2005 to December 31st, 2009. The main judgment criteria were the occurrence of postoperative pregnancy and its outcome.
  
  
  RESULTS
  Of 297 operated patients, 220 were interviewed by phone (74.1%), 124 (56.3%) had tried to obtain a pregnancy and 54 patients (43.5%) had 66 pregnancies (59.1% being live births and 25.8% miscarriages). For fertility after surgery, univariate analysis identified the number (more than 6, P = 0.0027) and an intramural location (P = 0.027) of myomas as negative factors and multivariate analysis identified age (over 35 years, RR = 2.45) and the association of other causes of infertility (RR = 2.21) as negative factors for pregnancy.
  
  
  CONCLUSIONS
  The modest conception rate (43.5%) after myomectomy among those women trying to obtain a pregnancy may be linked to the specificities of our population, and in particular its relatively high age and the frequent association of multiple causes of infertility.
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital of Pointe-à-Pitre/Abymes, Route de Chauvel, BP 465, 97159, Pointe-à-Pitre cedex, Guadeloupe, France, phnou@free.fr.
authors.forename: Daphné
authors.initials: D
authors.lastname: Borja de Mozota
authors.forename: Philippe
authors.initials: P
authors.lastname: Kadhel
authors.forename: Eustase
authors.initials: E
authors.lastname: Janky
mesh_terms: D000328:Adult; D005260:Female; D005298:Fertility; D019430:Guadeloupe; D006785:Hospitals, University; D006801:Humans; D007889:Leiomyoma / Q000601:surgery*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D016896:Treatment Outcome; D063186:Uterine Myomectomy; D014594:Uterine Neoplasms / Q000601:surgery*